Adjuvant chemotherapy in stage II and III colon cancer: the role of the “budding and TILs-(tumor-infiltrating lymphocytes) combination” as tumor-host antagonists

Lang-Schwarz, Corinna; Melcher, Balint; Dregelies, Theresa; Norouzzadeh, Zahra; Rund-Küffner, Stefanie; Lang-Schwarz, Klaus; Sterlacci, William

doi:10.1007/s00384-021-03896-9

Cited by 5 publications

(4 citation statements)

References 37 publications

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“…However, budding was also able to further stratify the low TIL cases into subgroups with different OS [22,25]. Recently, we could further show that the budding/TIL combination is able to identify patients in stage II and III CC with and without benefit from adjuvant treatment [33].…”

Section: Discussionmentioning

confidence: 90%

“…H&E-stained tumor slides of all patients were retrieved from our archives and re-evaluated independently in terms of budding according to the criteria of the ITBCC by two pathologists (CLS, BM) as described previously [25,33]. Budding was reported as proposed: low budding 0-4 buds (Bd1), intermediate budding 5-9 buds (Bd2), and high budding ≥ 10 buds (Bd3) [29].…”

Section: Histological Assessment Of Budding and Tilsmentioning

confidence: 99%

“…Assessment and reporting of budding as well as TILs on hematoxylin and eosin (H&E) stained slides have recently been well defined and validated by international groups [29][30][31][32]. We could previously show that the combination of tumor budding and TILs as tumor-host antagonists is able to further stratify patients with CC regarding overall survival (OS) and to identify patients in stage II and III CC regarding the benefit from adjuvant chemotherapy [22,25,33].…”

Section: Introductionmentioning

confidence: 99%

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Programmed death ligand 1 (PD-L1) in colon cancer and its interaction with budding and tumor-infiltrating lymphocytes (TILs) as tumor-host antagonists

Lang-Schwarz

Melcher

Hartmann

et al. 2021

Int J Colorectal Dis

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Purpose To analyze the role of programmed death ligand 1 (PD-L1) immunohistochemisty in the context of tumor microenvironment in colon cancer (CC) with focus on the interaction between tumor budding and tumor-infiltrating lymphocytes (TILs) and to elucidate its potential value for immunooncologic treatment decisions. Methods Three hundred forty seven patients with CC, stages I to IV, were enrolled. PD-L1 immunohistochemistry was performed using two different antibodies (clone 22C3 pharmDx, Agilent and clone QR1, Quartett). Tumor proportion score (TPS) as well as immune cell score (IC) was assessed. Budding and TILs were assessed according to the criteria of the International Tumor Budding Consensus Conference (ITBCC) and International TILs Working Group (ITWG). Correlation analyses as well as survival analyses were performed. Results PD-L1 positivity significantly correlated with TILs > 5% and MMR deficiency, and PD-L1-positive cases (overall and IC) showed significantly longer overall survival (OS) with both antibodies.The parameters “high grade,” “right-sidedness,” and “TILS > 5% regardless of MMR status” evolved as potential parameters for additional immunological treatment decisions. Additionally, TPS positivity correlated with low budding. More PD-L1-positive cases were seen in both high TIL groups. The low budding/high TIL group showed longer disease-free survival and longer OS in PD-L1-positive cases. Conclusion Overall, PD-L1 positivity correlated with markers of good prognosis. PD-L1 immunohistochemistry was able to identify parameters as additional potential candidates for immune therapy. Furthermore, it was able to stratify patients within the low budding/high TIL group with significant prognostic impact.

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Section: Discussionmentioning

confidence: 90%

Section: Histological Assessment Of Budding and Tilsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Programmed death ligand 1 (PD-L1) in colon cancer and its interaction with budding and tumor-infiltrating lymphocytes (TILs) as tumor-host antagonists

Lang-Schwarz

Melcher

Hartmann

et al. 2021

Int J Colorectal Dis

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“…Correlative examination of the consensus Immunoscore and tumor budding are not available; however, histological analyses of tumor-infiltration lymphocytes (TILs) in large populations of early-stage colon cancers have been performed. These data clearly support the benefit of assessing both TILs and MMR/MSI status; TILs assessment provides greater prognostic relevance than does tumor budding [ 42 , 43 ].…”

Section: Discussionmentioning

confidence: 63%

Impact of Immunoscore on the Management of Stage II Colon Cancer Patients: A Physician Survey

Kasi

Dotan

Poage³

et al. 2021

Cancers

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Background: Adjuvant chemotherapy use in stage II colon cancer is controversial. Current prognostic risk factors do not take the tumor immune microenvironment into account. Consideration of the Immunoscore, which measures the host immune response at the tumor site, may assist clinicians in reducing adjuvant chemotherapy use in patients who are unlikely to benefit from it. This study sought to determine the potential clinical utility of the Immunoscore, via its effect on medical oncologists’ recommendations for management of patients with stage II colon cancer. Methods: De-identified vignettes of 10 patients with stage II colon cancer were presented to 25 practicing medical oncologists. Each participant completed surveys indicating recommendations for adjuvant chemotherapy and surveillance strategies. An educational session was subsequently conducted, and the same patient profiles were re-presented but included immunoscore results. Participants were again asked to provide their recommendations. A participant was counted as influenced if their responses were altered after immunoscore test results were provided. Results: All but one participant (96%) altered a management recommendation for ≥1 case. For individual cases, a mean of 55% (range, 40–80%) of participants altered their recommendations for adjuvant chemotherapy and/or surveillance. For the immunoscore-high cases (low-risk of recurrence), recommendations for adjuvant chemotherapy use decreased from 60% to 31%. Conclusions: These results indicate a willingness by oncologists to integrate immunoscore information into clinical practice recommendations. Incorporation of immunoscore data resulted in the reduction of nonvalue care in the simulated population. Confirmation in prospective studies is planned.

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Frequency of Her2-low in colorectal cancer and its relations with the tumor microenvironment

Lang-Schwarz

Dregelies

Sterlacci

2023

Pathology - Research and Practice

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Adjuvant chemotherapy in stage II and III colon cancer: the role of the “budding and TILs-(tumor-infiltrating lymphocytes) combination” as tumor-host antagonists

Cited by 5 publications

References 37 publications

Programmed death ligand 1 (PD-L1) in colon cancer and its interaction with budding and tumor-infiltrating lymphocytes (TILs) as tumor-host antagonists

Programmed death ligand 1 (PD-L1) in colon cancer and its interaction with budding and tumor-infiltrating lymphocytes (TILs) as tumor-host antagonists

Impact of Immunoscore on the Management of Stage II Colon Cancer Patients: A Physician Survey

Frequency of Her2-low in colorectal cancer and its relations with the tumor microenvironment

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